Health Insurance · intermediate
Critical Illness Insurance
Critical illness cover explained — the lump-sum benefit, how covered illnesses are defined, waiting and survival periods, riders versus standalone policies, the tax deduction for premiums, and illustrative claim scenarios.
- 01What is Critical Illness Insurance — Definition, Coverage & Trigger EventsWhat critical illness insurance is, how its fixed lump sum differs from the reimbursement paid by an indemnity health policy, what counts as a trigger event, and where the cover sits in regulation and tax.
- 02Covered Conditions — Heart Attack, Stroke, Cancer, Kidney FailureHow a critical illness policy defines four conditions that appear in many policies' lists — heart attack, stroke, cancer and kidney failure — and why the definition, not the name of the illness, decides a claim.
- 03Survival Period & Claim ConditionsThe two time conditions in a critical illness policy — the waiting period, counted from the start of the policy, and the survival period, counted from the diagnosis — and the other conditions that must be met before the benefit is paid.
- 04Lump Sum vs Indemnity — How Critical Illness Payouts WorkThe two ways health insurance pays — indemnity, which follows the actual bill, and fixed benefit, which pays the agreed sum — and what the difference means when a person holds more than one policy.
- 05Critical Illness Riders vs Standalone PoliciesThe two forms of critical illness cover — a standalone policy and a rider on a life policy — how accelerated and additional riders differ, and the limits IRDAI sets on rider premiums and benefits.
- 06Tax Treatment — Premium Deduction (Section 126) and GSTThe income-tax deduction for health insurance premiums under section 126 of the Income-tax Act, 2025 — its limits, its conditions and the tax regime it belongs to — and the GST position on individual health insurance premiums.
- 07Claim Scenarios — Illustrative Approvals, Rejections & DisputesHow a critical illness claim is decided against the policy wording, the usual reasons a claim is paid or declined, what the 60-month moratorium does and does not do, and the routes open to a policyholder who disagrees.
- 08Choosing the Right Critical Illness Cover — Comparison FrameworkThe points on which critical illness policies differ and that matter when a claim arises — the list and its definitions, the waiting and survival periods, the payout structure, how long cover runs and how the premium changes — and where each is found.